HCV genotype 1a shows a better virological response to antiviral therapy than HCV genotype 1b
1 Liver Unit Azienda Ospedaliera San Camillo Forlanini, Circonvallazione Gianicolense, 87 00149, Rome, Italy
2 Liver Unit Ospedale Sandro Pertini, Via dei Monti Tiburtini 385, 00157, Rome, Italy
3 Department of Infectious and Tropical Disease Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
4 Liver Unit Policlinico Casilino, Via Casilina, 1049-00169, Rome, Italy
5 Liver Unit Ospedale Villa Betania, Via Niccolò Piccolomini 27, 00165, Rome, Italy
6 Infectious Disease Ospedale di Belcolle strada Sammartinese, 01100, Viterbo, Italy
7 Liver Unit Campus Biomedico University, Via Álvaro del Portillo, 21 00128, Rome, Italy
8 Infectious Disease Ospedale San Camillo de Lellis, Via John Fitzgerald Kennedy, 02100, Rieti, Italy
9 Department of Infectious Disease Policlinico Umberto I, Viale del Policlinico 155, 00161, Rome, Italy
10 National Institute of Health, Viale Regina Elena 299, 00161, Rome, Italy
11 Department of Digestive and Liver Disease, Azienda Ospedaliera Sant'Andrea, Via Grottarossa, 1035/1039, Rome, Italy
12 Medicine of Migration National Institute for Migrant Health and Poverty, Via di S. Gallicano 25/a, 00153, Rome, Italy
13 Department of Internal Medicine and liver unit Ospedale Generale di Marino, Viale XXIV Maggio, 00047, Marino Rome, Italy
14 Department of Medical Pathophysiology, University of Rome La Sapienza, Viale del Policlinico 155, 00161, Rome, Italy
15 Liver Unit ASL RM/A, Rome, Italy
16 Infectious and Parasitic Diseases, Policlinico San Matteo P.zzale Golgi,2, 27100, Pavia, Italy
BMC Gastroenterology 2012, 12:162 doi:10.1186/1471-230X-12-162Published: 16 November 2012
The impact of viral subtype on the rate of sustained virological response (SVR) to antiviral therapy in patients chronically infected with hepatitis C genotype 1 subtype 1a and 1b has not been extensively investigated. The aim of this study is to determine whether the HCV genotype 1 subtypes 1a and 1b respond differently to treatment with PEGylated interferon (PEG-IFN) plus ribavirin.
For 48 weeks, 388 “naïve”genotype 1 patients were treated weekly with PEG-IFN α-2a or PEG-INF α-2b combined with daily ribavirin (1000–1200 mg/day). The numbers of patients in whom HCV-RNA was undetectable were compared after 4 (rapid virological response, RVR), 12 (early virological response, EVR), and 48 (end treatment virological response, ETR) weeks of treatment as well as 24 weeks after the last treatment (sustained virological response, SVR).
The rate of SVR was higher in subtype 1a patients than subtype 1b patients (55% vs. 43%; p < 0.02). Multiple logistic regression analysis showed that infection with genotype 1a (odds ratio(OR) : 1.8; 95% confidence interval (CI): 1.4 to 4.1), age < 50 years (OR:7.0; 95% CI 1.1 to 21.2), alanine aminotransferase level (ALT)<100 IU/ml (OR:2.1; 95% CI: 1.3 to3.5), HCV-RNA < 5.6 log10 IU/ml (OR: 3.2; 95% CI: 2.7 to 6.9) and fibrosis score < S3 (OR: 3.8; 95% CI:3.2 to 7.4), were all independent predictors of SVR.
Dual antiviral therapy is more effective against HCV subtype 1a than against subtype 1b and this difference is independent of other factors that may favour viral clearance.
ClinicalTrials.gov Identifier: NCT01342003